Sex Addiction Appears to be Increasing, But Condition is Treatable

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San Francisco psychotherapist Michael Halyard, MFT explains how sex addiction appears to increasing due to technology. Halyard explains the different types of sex addiction, the sex addiction cycle, possible causes, and the treatment that is currently available. Halyard is a licensed Marriage and Family Therapist and runs the websites http://www.sftherapy.com/ and http://www.sanfrancisco-psychotherapy.com.

Both sex addicts and sex and love addicts leave a path of destruction in their wake. The consequences include STD’s, HIV--and passing diseases on to their partner. Consequences also include ruined relationships and families due to infidelities and affairs

The same technology that has revolutionized society--that people now rely on every day for information, communication, and to stay connected--may be spurring an increase in sex addiction.

"Therapists are seeing more sex addicts in their practices, and recent studies suggest technology is behind the increase. There are people who are now sex addicts who clearly wouldn’t have gotten there without the Internet,” says San Francisco psychotherapist Michael Halyard, MFT.

Halyard is a licensed Marriage and Family Therapist and runs the websites http://www.sftherapy.com/ and http://www.sanfrancisco-psychotherapy.com.

Sex addiction, like drug and alcohol addiction, is a debilitating condition that wrecks havoc in people’s lives, and can cause major problems for their partners, spouses, and families. The two main features of sex addiction are the recurring inability to control their sexual behavior and continuance of the behavior despite harmful, negative consequences. Three to six percent of the population are thought to be sex addicts, but this may be an under estimate due to the stigma.

“The Internet makes sex available at any time-both as a means for meeting people, and as a way to have sex on the computer, known as cybersex, through webcams and instant messaging. There are tons of hook-up websites-and these make it easy for sex addictions to develop and go into overdrive. The Internet also has millions of porn sites--12% of all websites-- with billions of dollars in annual revenue,” says Halyard.

Although sex addiction is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association, Halyard says it should be adopted in the next revision.

“Clinicians who work regularly with sex addicts will tell you that it is an addiction, because the disorder has all the hallmarks of addiction, including causing significant distress, tolerance, withdrawal, increasing time spent and intensity, behavior continuing despite negative consequences or the desire to stop, and causing problems in occupational and social functioning,” reveals Halyard.

Behaviors associated with the disorder vary from individual to individual, but usually include sexual obsession or fantasy, excessive masturbation, multiple sex partners, affairs, and numerous one night stands. On the Internet, behaviors can include online porn, meeting online and having sex, cybersex, instant messaging, texting, webcam, and online strippers. Sex addicts attempt to connect with other people by means of decidedly impersonal intimate activities. For heterosexual males, the addiction often involves visits to strip clubs, massage parlors, escorts, live call chatting (1-900 numbers), and prostitutes.

“For gay men, at least in urban areas, it’s easy to have compulsive sex with lots of available men wanting the same thing. Gay culture tends to normalize compulsive sex--so there is often less prostitution but more cruising on the Internet and in bars, parks, and adult bookstores. There are tons of gay hookup websites, and even a new I-Phone application that uses a GPS located in people’s phone to find men close by who are also looking for sex. For some, sex addiction sometimes co-occurs with a crystal meth addiction, known as Party and Play addiction, which is a dangerous combination,” says Halyard.

For some, sex addiction can even include behaviors like exhibitionism, voyeurism, and frotteurism, S&M, violence and dangerous sex, cross-dressing, fetishistic sex, sexual asphyxiation, and inappropriate sex partners.

Halyard says sex addiction can also take the form as a pornography addiction. “For many adults, the moderate use of pornography can be a healthy part of their sexuality. For porn addicts, however, pornography can be as damaging as gambling, alcohol or drugs, and can take over a person’s life.”

Pornography addiction is a psychological dependence upon pornography, characterized by compulsive reading, viewing and obsessing about pornography to the detriment of a person’s well being and affecting all areas of their life. The disorder appears to be progressive, like other addictions, and can get worse without treatment. Online internet pornography is more addictive than traditional pornography due to its easy availability, explicit nature, wide range of images and video available, and the privacy that the online experience offers. Many addicts spend hours searching the Internet for the newest or most hardcore pornography.

“Sex addicts progress through a predictable cycle, outlined by Dr. Patrick Carnes. Because sex addicts are unable to cope with pain in a healthy way, the cycle usually starts when the individual is under stress or when having some other uncomfortable feelings like anxiety, depression, anger, or hopelessness. The addict initially goes through a period of obsession about a given sex act, and detaches from his or her feelings. In time, the desire for sexual activity increases and the individual’s behavior is increasingly motivated by the relentless drive to experience that sex act. A sex addict may go cruising or go to a strip club to increase arousal until past the point of being able to say no. Sex addicts are not able to control their sexual impulses and finally give into the fascination and allure of the sex act for which they’ve been waiting--and have sex. The built up tension that the sex addict feels are eased when the fantasy is put into action--but the sex addict only feels better temporarily. Before long, reality sets in, and the sex addict starts to feel ashamed and remorseful. In time, the sexual activity causes problems in an individual’s life, and progressively gets worse. The one fail proof method to alleviate feelings of anguish is to begin obsessing yet again. Thus the cycle then perpetuates itself and continues,” says Halyard.

Sex and love addiction is a variation of sex addiction--but in addition to a compulsive desire for sex--it can include an excessive dependency on a person (or several people) and a constant obsession with romance, fantasy and intrigue. For the sex and love addict, it’s not just the sex that is compulsive--it’s also emotional relationships that are unhealthy and damaging. Sex and love addicts often move from relationship to relationship, have affairs, and multiple sexual liaisons to feel the high and intensity that comes with infatuation. Sex and love addicts often use manipulation, control, shame, guilt, and seduction to draw in and hold onto their romantic partners. Sex and love addiction can also reveal itself in anorexia--which is the compulsive avoidance of receiving or giving sexual, emotional, or social nourishment.

“Some clinicians believe sex addiction is caused by a childhood lacking in “good enough parenting,” where a person develops negative core beliefs--for example ‘I’m bad’--that are so uncomfortable that they propel the person in addiction. Another theory proposes that certain people are physiologically prone to certain types of addictions due to brain chemistry. It could also be true that the negative core beliefs or childhood trauma actually affect brain chemistry, setting the stage for addiction. What’s probably true is there is an interaction between nature (brain chemistry) and nurture (childhood) that brings about sex addition,” argues Halyard.

The reward center in the brain directs all behavior where motivation plays a central role, including obtaining food and having sex. Problems in the brain’s reward center are seen to lie beneath all addictive behavior. Science is now showing us this is why addicts continue addictive behavior in spite of ever increasing negative consequences--sex addicts may have chemical imbalances that set the stage for an addiction to take hold.

“Both sex addicts and sex and love addicts leave a path of destruction in their wake. The consequences include STD’s, HIV--and passing diseases on to their partner. Consequences also include damaged relationships and families due to infidelities and affairs,” says Halyard.

“These are serous addictions, but there is hope. Sex addicts can receive treatment from private practice psychotherapists, clinics, and out-patient and in-patient programs. The impediment to treatment is often denial, because people don’t want to think they have a problem, and they often are embarrassed to seek help. If you think of this as your brain not working right through no fault of your own, it should lessen the shame,” adds Halyard.

For recovery to take place, sexual sobriety has to be defined. For alcoholics, defining sobriety is easy, but sex addicts (or sex and love addicts) must carefully contemplate their abstinence list. These bottom line behaviors are the behaviors that need to be avoided in order to maintain sexual sobriety. Making an abstinence list can be done with a sponsor or with a therapist.

“Often it is helpful to make a sexual recovery plan that has three circles. The innermost circle contains the abstinence list (i.e. sex outside of relationships or anonymous sex, watching pornography.) The middle circle includes behaviors that are triggers and behaviors that the addict should avoid because they could lead to a relapse (i.e. flirting or scanning people in a sexual way). The outermost circle has healthy behaviors that the addict needs to be doing to maintain sobriety and have healthy relationships and sexuality (i.e. going to the gym, communicating with your partner). Sexual sobriety does not mean not having sex (sexual anorexia), it means having sex in healthy ways. The addict gets to choose what their bottom-line behaviors are, and they can change the plan if it’s not working. Sexual sobriety is defined as the contract the addict makes with their therapist or 12-step sponsor,” reveals Halyard.

Psychotherapy is helpful for sex addiction, and involves confronting denial and rationalization and making a sexual recovery plan. Part of that process is figuring out what the triggers are for acting out, and learning how to avoid them. Treatment also involves figuring out what an individual’s healthy sexual practices are and teaching people to cope with their urges. Learning new coping skills is essential because the acting out behaviors was the way the addict historically responded to stress.

Sex Addicts Anonymous, Sex and Love Addicts Anonymous and Sexual Compulsive Anonymous are 12 step groups based on Alcoholics Anonymous. These self-help / mutual-support groups are well-liked and effective at helping sex addicts achieve and maintain sexual sobriety.

“Like alcoholism, sex addiction creates lots of wreckages in the form of damaged relationships due to sexual acting out, infidelity, affairs, and multiple simultaneous relationships. The 12-steps offer a good way to take an inventory of your life and set things right with people who have been harmed,” explains Halyard.

Medication has also been shown to be effective in treating sex addiction. Naltrexone helps to reduce the euphoric effects of tension buildup and fantasy, which happens before sexual acting out. Selective Serotonin Reuptake Inhibitors--like Prozac-- decrease the obsessional thinking, preoccupation, urges, cravings, and emotional reactively associated with sex addiction, thus reducing the compulsive behavior.

For those with pornography addiction, Internet monitoring or Internet filtering (designed to keep children from seeing adult images and content) helps reduce accessibility and can prevent a relapse. The filters provide an external deterrent to a relapse and are very helpful.

“The good news is that people do recover. Sex addiction, sex and love addiction, and pornography addiction are all very treatable. Life in recovery means people are able to build self-worth authentically and have a life free of sexual obsession. A healthy sex life is also possible, based on respect for oneself and respect for one’s partners,” adds Halyard.

About Michael Halyard. Michael Halyard, MFT, MBA is a licensed Marriage and Family Therapist and provides counseling and psychotherapy in his San Francisco private practice. He specializes in addictions, depression, anxiety, couples counseling and LGBT issues. He also runs the web sites http://www.sftherapy.com/ and http://www.sanfrancisco-psychotherapy.com.

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